A case of mandible plasma cell myeloma is reported.Plasma cell myeloma is a monoclonal neoplastic proliferation of plasma cells of bone-marrow derivation,usually multi-centric but jaw bones are rarely involved.The treatment requires precise pathological diagno-sis.The prognosis of solitary jaw bone lesions can be good after treatment.

Objective To study the chemical constituents of Hedyotis tenelliflora. Methods The compounds were isolated by chromatographic separation technology. The structures were identified on the basis of chemical and spectral data. Results Four iridoid glycosides were isolated from the whole plant of H. tenelliflora. On the basis of the chemical and spectral methods, their structures were elucidated as teneoside C (1), harpagoside (2), harpagide (3), and asperulosidic acid (4). Conclusion Compound 1 is a new compound, and compounds 2 and 3 are isolated from H. tenelliflora for the first time.

BACKGROUND:Establishing the animal model of membranous nephropathy is of importance to figure out the pathogenesis of membranous nephropathy.
OBJECTIVE:To investigate the expression of nephrin and podocin in the model of membrane nephropathy in rats, and to investigate their relationships with the pathogenesis of membranous nephropathy.
METHODS:A total of 40 Sprague-Dawley rats were equivalently randomized into model and control groups. Rats in the model group were in premunity by given subcutaneous and multi-point injection of 1 mg cationic bovine serum albumin firstly dissolved in 0.5 mL normal saline and then ful y emulsified with the equal incomplete Freund’s adjuvant for 1 week, and 16 mg/kg cationic bovine serum albumin was injected via vein tails, once every other day for 4 weeks. The same volume of normal saline was injected into the controls. The mRNA expressions of nephrin and podocin in renal tissues were detected using real-time PCR, and biochemical indicators and morphological observation were measured at 2 and 4 weeks after modeling.
RESULTS AND CONCLUSION:(1) In the model group, the total amount of urine and serum albumin levels were significantly decreased accompanying with overt proteinuria, and the serum creatinine, urea nitrogen, cholesterol and triglyceride levels were significantly increased al in a time-independent manner compared with the control group (P<0.01), and the difference was significant (P<0.05). (2) The pathological examination showed that rats in the model group had different degrees of renal tubular dilatation, glomerular basement membrane thickening, mesangial cel s and stromal hyperplasia, which was typical of membranous nephritis. (3) Moreover, the mRNA expressions of podocin and nephrin in the model group were lower than those in the control group. (4) In conclusion, the decreased expressions of podocin and nephfin may disturb the integrity of the slit membrane of podocytes giving rise to the damage of glomerular filtration barrier, and proteinuria appears in final.

Objective To evaluated the improving effect of training method of point-line-plane on development quotient in premature infants with brain injury.Methods 174 cases of premature children with brain injury were randomly divided into study group (89 cases) and control group (85 cases).Control group given Bobath and Vojta traditional rehabilitation training,and the study group was given training method of point-line-plane.Patients in both groups were evaluated synthetically based on The Evaluation Chart on Neu-robehavioral Development of Children Aged 0-6 Years,developed by Capital Institute of Pediatrics,prior to the treatment,and after the first,the second,and the third course of the training programs,respectively.Re-sults The score of developmental quotient ( DQ) between study group and control group was no significantly different(P>0.05).Compared with before treatment, the scores of DQ was significantly increased after the first, the second and the third course of training treatment in study group and control group((82.71±12.28) vs (81.17±9.63), t=0.859, P>0.05;(89.65±10.02) vs (87.02±7.39), t=1.747, P>0.05). Compared with the control group, the scores of DQ in study group was no significant difference after the first and the second course of treatment,but there was significantiy different after the third course treatment((95.26±8.87) vs (91.31±7.63), t=2.945, P=0.004).Conclusion The training method of point-line-plane can improve the clinical efficacy of premature infants with brain injury at the early phase, which is worth widely applying in clinical practice.

Key word: Hedyotis L ; triterpenoids; spectroscopic characteristics

Objective To explore Sex differences of total homocysteine(tHcy) levels,and relationship between serum creatinine and homocysteine,and renal regulation to homocysteine in patients with cerebrovascular diseases within normal serum creatinine concentrations. Methods The levels of fasting serum tHcy?Scr?triglyceride(TG)?total cholesterol(TCHO)?high density lipoprotein cholesterol(HDL-C)?high density lipoprotein cholesterol(LDL-C)were determinedin groups of cerebral infarction(CI,278 males and 160 females),cerebral hemorrhage(CH,22 males and 16 females)and transient ischemic attacks(TIAs,27 males and 20 females).The situation that patients along with hypertension and diabetes mellitus were also investigated in three groups. Results Comparison in three groups:the tHcy concentrations were significantly higher in CI than in TIAs(P 0.05). Sex comparison(327 males,196 females,from CI,CH,TIAs):the tHcy concentration were significantly higher in males than females[P

Targeting the key questions in the scale development process of TCM syndrome, such as the definition of the concept, the construction of the theoretical framework, the quantitative classification of the items, the rational use of the statistical methods and so on, this article put forward that on the basis of carefully distinguishing the three concepts of syndrome diagnosis, syndrome evaluation and disease diagnosis, and based on TCM dialectical thinking and mathematical validation to build theoretical framework. A scientific and reasonable quantitative classification method was established based on the reliability and validity as indexes. Non-linear intelligent mathematical statistics and symptomatic index groups were used to analyze the ideas and methods of data mining, with a purpose to improve and perfect the methodology of the development of syndromes scale and to improve the establishment and application of the syndrome scale.

To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone (AMH).A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy (TLH group,n =32),laparoscopic subtotal hysterectomy (LSH group,n =31) and laparoscopic myomectomy (LM group,n =33).Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation.No significant differences existed in AMH in LM group[(1.42 ±0.65),(1.31 ±0.53) & (1.33 ±0.61) μg/L,P ＞ 0.05].The levels of AMH in both groups were significantly lower than those at pre-operation [(1.17 ± 0.11),(1.01 ±0.10),(0.48±0.54) & (1.18±0.93),(0.45 ±0.39),(0.14±0.0) μg/L,P＜0.001].The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up [(-37.4 ± 37.6) ％ vs.(-27.0 ± 23.0) ％,P =0.017].The results showed that LM had no effect on ovarian reserve.Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

Objective To investigate the relationship between blood vessel invasion (BVI) and clinicopathologic features and prognosis in patients with gastric cancer,and analyze related factors affecting the prognosis of patients.Methods The clinicopathological data of 206 patients with gastric cancer who were admitted to the Nanjing Hospital Affiliated to Nanjing Medical University from January 2007 to December 2010 were retrospectively analyzed.The BVI of surgical tumor specimens in all patients was detected by immunohistochemical staininng.All the patients were followed up via outpatient examination and telephone interview up to March 2014.The count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The BVI rate of 206 patients was 27.67％ (57/206).The BVI rate of tumor tissues,tumor differentiation,perineural invasion,T stage,N stage and TNM stage in all patients with gastric cancer were compared,showing significant differences (x2=14.396,9.569,15.579,43.453,30.732,P ＜ 0.05).After operation,188 patients were followed up for 6.0-60.0 months (median,34.0 months),with the follow-up rate of 91.26％ (188/206).Among 188 patients with follow-up,the median survival time and 5-year cumulative survival rate in patients with BVI and with negative BVI were 32.4 months and 19.6％,40.7 months and 42.0％,respectively,with a significant difference in the survival of patients (x2 =9.364,P ＜ 0.05).The results of univariate analysis showed that the diameter of tumor,tumor differentiation,perineural invasion,BVI,T stage,N stage and TNM stage were factors affecting the prognosis of patients with gastric cancer (x2=9.241,17.486,11.243,9.364,27.666,216.745,49.887,P ＜ 0.05).The results of multivariate analysis showed that the diameter of tumormore than 5 cm,BVI,stage T4,stage N3 and stage Ⅲ were independent risk factors affecting the prognosis of patients with gastric cancer (HR =0.502,0.456,0.052,0.001,0.735; 95％ confidence interval:0.334-0.754,0.289-0.720,0.004-0.664,0.000-0.006,0.159-3.398,P ＜ 0.05).Conclusions BVI in patients with gastric cancer is associated with the progression of tumors.The diameter of tumor more than 5cm,BVI,stage T4,stage N3 and stage Ⅲ are independent risk factors affecting the prognosis of patients with gastric cancer,and BVI may be a predictor of poor prognosis of patients with gastric cancer.

Objective:The objective of this study was to evaluate and compare the core attributes of the four general practice models in Guangzhou, Dongguan and Shenzhen, and to provide the suggestions for strengthening the general practice functions. Methods: We used the two stage sampling method in this study. Firstly, three CHCs in Guangzhou, two in Dongguan and two in Shenzhen, and the general medical outpatient department in the Shenzhen Hospital of the University of Hong Kong were selected. Secondly, we used the convenience sam-pling method to perform investigation. A PCAT-AE modified Chinese edition was adapted to measure the patients’ primary care experience. A total of 1 712 patients participated in the questionnaire survey, the number of which 1 645 copies were valid. Results: Generally, the general practice core attributes’ total scores from that hospital were higher than those from Guangzhou communities (55. 3 vs. 45. 9, P<0. 05), Dongguan commu-nities (55. 3 vs. 49. 2, P<0. 05) and the Shenzhen communities (55. 3vs. 51. 7, P<0. 05). Conclusion:The primary care implementation was different in accordance with the characteristics of regions, and the general practice core attributes had different characteristics in different models. It could constantly improve the primary care services to each model’s specific circumstances.